Individual provider Active NPI

Lisa L Smith, MD

  • Family Medicine Physician
  • Toledo, OH
National Provider Identifier
1932104072
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35070156 Issued in OH
Practice address
4805 Suder Avenue
Suite a
Toledo, OH 43611-1800
Phone
(419) 726-1585
Fax
(419) 726-0381
NPI assigned
Jun 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35070156 OH Primary

Addresses

Primary practice location

4805 Suder Avenue
Suite a
Toledo, OH 43611-1800

Mailing address

4235 Secor Rd
Toledo, OH 43623
Phone (419) 473-3561

Other identifiers 1

IdentifierTypeStateIssuer
2020119MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050310000492 OH Practitioner - Family Practice 6901850718 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35070156OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Toledo Clinic Incorporated CurrentSince Mar 1, 2007 Accepting new patients
Toledo Clinic Incorporated Family Medicine Current Accepting new patients
Toledo Clinic Incorporated Current Accepting new patients
Toledo Clinic Incorporated CurrentSince Mar 1, 2007 Accepting new patients

Locations

4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214

4805 Suder Ave
Ste A
Toledo, OH 43611
Phone (419) 726-1585

Interoperability endpoints

  • Direct secure messaging: lisa.smith@toledoclinic.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264377600000",
    "number": "1932104072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43623",
            "telephone_number": "419-473-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 SUDER AVENUE",
            "address_2": "SUITE A",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436111800",
            "telephone_number": "419-726-1585",
            "fax_number": "419-726-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LISA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2010-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35070156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2020119",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.